Doula Care Case Study

There are many things in life are great gifts, and being a parent is one. Getting the news that you are expecting a child is a speechless moment. It is a very joyful occasion and everyone is happy about what to expect over the next nine months. Baby names start flowing and in every magazine you are looking at outfits and furniture and things of that nature. But has anyone stop to think about what is cost to have this baby? What medical expenses that will be incurred during this forty weeks process. The answer is no. No one probably really cares but the hospital and the insurance company. Now it’s time to take a look at some of the cost behind the blessing of labor and delivery.

The health nurse can be a great advocate in identifying both the current and future needs of the parent and baby. Many community services are available to assist with nutritional needs, prenatal care services, and future childcare needs (Kaakinen, Coehlo, Steele, Tabacco, & Hanson, 2014). I myself was once a young pregnant mother who required assistance. Working a part-time minimum wage job while pregnant with my first child and attending nursing school full-time, I struggled financially. Before the time of healthcare reform, first-time pregnant mothers did not receive governmental assistance for health insurance or prenatal care. The community service that aided me during that time was the Women, Infant, and Children (WIC) program. Without the assistance of those wonderful nurses and program, I would have suffered from times of inability to buy food for myself while pregnant and would have also struggled to buy formula for my newborn. Not only was the food assistance godsend, the practical and applicable knowledge I gained from the nurse educators was

Providing an effective care and support to the patient and for their babies during labour

Major disparities continue to exist in spite of America’s “Affordable Care Act”, Although minorities suffer disease five times greater than the rest of the nation, minorities represent the majority of the disparity. Infant Mortality has always been America’s indicator as to the state of the countries health status. America is one of the wealthiest and most powerful nations in the world, However, America ranks number 24th in the world for infant mortality. Puerto Rican and Indian women rank highest among ethnic classes with low infant mortality rates. Some researchers have found lack of prenatal access as the key contributing factor to low mortality and birth weights among these two ethnic classes.

Birth Hands Doula Service is a full-service doula agency that is located in Greensboro, North Carolina. Birth Hands Doula Service serves the Piedmont area of North Carolina including Greensboro, Burlington, Hillsborough, Chapel Hill, and Durham. Their goal is to render a well rounded, woman-centered care throughout the entire pregnancy, birth, and early postpartum. This care constitutes education, advocacy, emotional, and physical support for the women, the parents, their families, and their desired support team. Their services include labor and birth support, birth plan consultation, birth partner support, recording the client’s birth story, blessingway or baby shower celebration, and postpartum support services. The doula of Birth Hands

Johnson et al. emphasize lower cesarean section rates of physician-mothers under physician-induced demand (2). One reason concerns higher reimbursement of surgical births rather than vaginal deliveries, which functions as a non-medical factor. Financial incentives are imposed on uninformed patients so that cesarean deliveries become more frequent in the health environment. Despite the non-medical factors applying cesarean sections should be regarded in terms of maternal mortality and morbidity. In addition, performing the vaginal delivery safely could involve more resources and treatment of any arising complications during the birth. Patients’ knowledge about interventions could achieve larger cuts in cesarean section

Also, for reasons that are still being investigated in public health, poorer pregnant women are much more likely to be diagnosed with labor-inducing bacterial infections such as bacterial vaginosis or chorioamnionitis (inflammation of the fetal membrane) (Allsworth & Peipert, 2007; Dammann, Leviton, & Allred, 2000). In a study sample of over 3,700 women who participated in the National Health and Nutrition Examination Survey, the prevalence of bacterial vaginosis was higher in pregnant women who were living at (34%) or below (37%) the federal poverty level compared to those who were living above it (24%) (Allsworth & Peipert, 2007). Additionally, pregnant women in lower SES communities have been found to suffer from more chronic healthcare care conditions such as hypertension and diabetes which are highly associated with preterm birth and small gestational size (Nagahawatte & Goldenberg,

This research papers purpose was to assess the impact of Medicaid expansion on pregnant mothers and their newborn children. Issues explored were the history Medicaid, current perceptions regarding the program and its recipients, the benefits of Medicaid and the reasons that some states have chosen to opt out of the expansion. The methodology used for this study was to research peer reviewed articles and journals to determine the positive and negative effects of Medicaid expansion and compare data from states that have implemented program expansion to those states that have chosen to abstain. Information was gathered from all stages of development from conception, to school age children. When comparing the potential advantages and costs of Medicaid expansion the research findings indicate a substantial benefit regarding access to care, prenatal and postnatal services for mothers with Medicaid as compared to those mothers without insurance. Although Medicaid insurance and benefits are costly, research data indicated that providing these services can result in a significant savings by offering preventative screening and by avoiding the utilization of expensive emergency services. Additionally, research indicated that Medicaid recipients reported better rates of health care satisfaction and wellbeing than those who were uninsured.

This research consisted of key informants and general informants. These general informants were leaders in the community, granny midwives and African American and European American health care professionals. These general informants came from the clinics and hospitals where key informants were from. The key informants from each region were women who were either pregnant or had a baby within in a year preceding the study. (Marjorie Morgan, 1996)

Pregnant mothers are viewed as a business made for doctors and hospitals as insurances typically cover infant birth and hospital bills. As Patricia Burkhardt, Clinical Associate Professor, NYU Midwifery Program could not speak the truth any better, she states, “Hospitals are a business. They want those beds filled and emptied. They don’t want women hanging around the labor room.”

Carolina Birth and Wellness is a full-service doula agency that is located in Chapel Hill, North Carolina. Carolina Birth and Wellness offers doula support, massage therapy, and infant massage classes to families. Their doula services include birth doula, postpartum doula, sibling doula, birth planning consultation, belly casting, belly binding, and operation special delivery. Carolina Birth and Wellness supports all the families in North Carolina, including the LGBT communities.

We have heard of people being hired as professional bridesmaids, but what about people being hired as professional doulas. Just like it may sound weird to have a stranger in a wedding party, it may sound weirder to have a stranger in the birthing room. However, both professionals offer support during monumental events, and can make a huge impact on experiences. A birth doula is a woman who is hired to provide continuous support to a mother before, during, and immediately after childbirth. Over time, a doula builds a relationship with the mother to know exactly what environment and support her, her loved ones, and her midwife would need.

Next, a non-hospital birth usually has midwifery or Doula. Midwifery is a profession in which providers take care of pregnant women during her labor and birth and during the postpartum period. Assisting the mother with the child after it is born. According to “Human Sexuality: Diversity in Contemporary America,” midwives attends the majority of births. Midwives are qualified for routine deliveries and minor medical emergencies; often operating as part of a medical term. As Cara Muhlhahn, a certified nurse midwife stated in “Business of Being Born,” she would rather be in the home of the patient so she would feel comfortable. And most women who have midwives are comfortable because they are in the privacy of their own home giving birth to their child and they feel empowered instead of the powerless vibe in a hospital. A Doula, on the other hand, does not have to make clinical decisions. Doulas offer emotional support and manage pain using massage, acupressure, and birthing positions; making it easier for the mother to cope with her complications. According to “Mothering the Mother: How a Doula Can Help You Have a Shorter, Easier and Healthier Birth,” a Doula is a Greek word that literally means a woman who has experience that can help other women. Klaus Kennell and others who have researched the effects of the doula's presence during childbirth have come to define the term as a woman with experience in childbirth who will give the laboring mother emotional, physical and

In many U.S. hospitals today the patient care that women receive during management of labor and delivery doesn’t look very evidenced based. Electronic fetal heart rate monitoring (EFM) is the most common form of intrapartal fetal assessment in the United States. We continue to see widespread use of EFM in low risk pregnancies. Electronic fetal monitoring is standard procedure despite numerous randomized controlled trials that have disproven its validity. It is routinely used, yet does not decrease neonatal morbidity or mortality compared to the use of intermittent auscultation. Intermittent auscultation of the fetal heart rate is an acceptable option for low-risk laboring women, yet it is underutilized in the hospital setting. Several expert organizations have proposed the use of intermittent auscultation as a means of promoting physiologic childbirth. So why do we use continuous EFM in the low risk pregnancy and what does the best evidence support and how can nurses apply the best available evidence to practice? As a patient advocate it is the nurses responsibility to answer these questions and provide the low-risk pregnant woman with current evidence about options for fetal heart rate assessment during labor.

Prenatal care is widely accepted as an important element in improving pregnancy outcome. (Gorrie, McKinney, Murray, 1998). Prenatal care is defined as care of a pregnant woman during the time in the maternity cycle that begins with conception and ends with the onset of labor. A medical, surgical, gynecologic, obstretic, social and family history is taken (Mosby's Medical, Nursing, and Allied Health Dictionary, 1998). It is important for a pregnant woman as well as our society to know that everything that you do has an effect on your baby. Because so many women opt not to receive the benefits of prenatal care, our society sees the ramification, which include a variety of complications primarily